Individual
GRACE ANNE MCCULLOUGH
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
ATC
Contact information
Practice address
4202 E FOWLER AVE, TAMPA, FL 33620-8000
(813) 974-8312
Mailing address
PO BOX 1025, CHINA, TX 77613-1025
(409) 998-5389
Taxonomy
Speciality
Code
Description
License number
State
2255A2300X
Athletic Trainer
Primary
—
—
Other
Enumeration date
07/06/2023
Last updated
07/06/2023
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